Family and friends

Since the shift away from institution-based care to community-based care in Australia, family members and friends have increasingly come to be seen as potential support persons for people with severe mental health problems. Under the Victorian Mental Health Act 2014, people diagnosed with a mental illness have the right to appoint a family member or friend as a ‘Nominated Person‘, responsible for representing their interest should they be subject to compulsory treatment (see also Support in treatment decisions, Support in life decisions, How to increase participation in decision making and Community Treatment Orders).

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Forms of support
Talking about mental health
Advice and advocacy
Relationships with friends and family and mental health

The people we talked to described varied experiences and expectations of their involvement with family and friends, and the impact of family members and friends on their lives. They discussed the different forms of support they received from family or friends and how they felt about being able to talk with them about their mental health. They also commented on their reactions to advocacy and advice from family members or friends, and the connections between their family relationships and friendships and their mental health.

Forms of support

For those experiencing severe mental health problems, relatives and friends can be an important source of support. The people we spoke to described receiving various forms of support and care including a place to stay, support during treatment and appointments, and food. Sarah moved back home with her parents after she became ‘unwell’ and ‘ended up forming a really strong relationship’ with them. Nicky described how her parents ‘protected’ her when she was on medication that had very strong side-effects by regularly ‘taking her out … on drives’. A few people said that their families helped them to access mental health services and practitioners, including Niall whose stepmother recommended a psychiatrist who had been suggested to her.

Gurvinder said his mother brings him cooked meals and talks to him, which he said helps ‘dim down’ the voices that he hears.

Talking about mental health

Many people discussed whether they felt able to talk to family members or friends about their mental health. Some people said they felt comfortable talking to their family or friends, and appreciated their interest. Helen described one friend who often called her to ask, “Are you okay?” as ‘a blessing’, while Niall said his father showed interest in his appointments with his psychiatrist, which he valued. Others would have liked to talk about their mental health problems with family members, but their family members were not ‘open’ to this. Carlo said his ex-wife’s reluctance to discuss his diagnosis of bipolar disorder made it feel less ‘permissible’ for him to talk about his experience with her. For some, ‘stigma’ around mental illness amongst their parents’ generation meant they did not feel able to speak openly with their parents about their mental health (see also Discrimination and social responses to mental health problems).

David said his family’s discomfort with ‘talking about mental vulnerabilities’ had impacted on their degree of involvement in his life.

A few people preferred to initiate conversations with family about their diagnosis or treatment, rather than simply responding to their questions or comments. Others discussed their diagnoses with specific family members or close friends. Michelle said she felt she ‘could only really talk to’ her daughter about her mental health experiences.

Helen described her conflicting feelings about seeking support from her adult daughters about her ‘problems’.

Advice and advocacy

Some people discussed receiving advice from their family and friends, or support during decision-making about treatment. Advice was mostly appreciated. Niall said his father gave him ‘good advice’, which Niall listened to before deciding whether to act on it. However, David described his parents and sibling’s advice that he should ‘just choose to be better’ as ‘difficult’. Some people valued being told by family members or friends that they seemed to be becoming ‘unwell’. Helen wanted her family to ‘take a stand’ and recommend she go to the doctors if they noticed signs she was becoming unwell.

Paddy said he ‘tries to listen to family and friends’ if they tell him that they think he is becoming ‘unwell’.

A few people said they felt their family was not involved enough in decision making about treatment. During Alice’s first hospitalisation (a voluntary admission), her family ‘left it to the medical professionals to make the decisions’. She was then made subject to compulsory treatment. Her family have since acknowledged that they ‘should have’ helped her more at that time. Others described resenting the involvement in decision making regarding treatment of family members or friends whom they felt did not have their best interests at heart.

Helen said she and her ex-husband had disagreed over her choice of psychiatrist.

Relationships with friends and family and mental health

Many people talked about the impact of relationships with family members and friends on their wellbeing, as well as the impact of mental ‘illness’ on those relationships.

Several people discussed the differences between the support offered by friends who had lived experience of severe mental health problems, and those without. Some, like Ann, said they had friends who were both ‘well’ and ‘unwell’. Others valued their friendships with people who had received the same or similar diagnoses. Taylor said she gained ‘more understanding’ from her relationship with a friend diagnosed with bipolar disorder because her friend had ‘been through’ an experience similar to hers.

Brendan appreciated his friends who ‘understand’ and recognise that he did not ‘choose to ‘be unwell’.

Some people spoke about friends who had an impact on their health, either positively or negatively. Bernadette was grateful for a friend’s advocacy on her behalf, which led to her being discharged from a mental health unit after a lengthy stay. Others talked about having to end certain friendships, like Maria who described letting go of friends who ‘upset’ her in order to ‘protect’ herself.

Vanessa said her family and old friends live interstate and she spends ‘a lot of time alone’, which sometimes makes her feel ‘deeply sad’. Learning recently about a friend’s terminal illness has shifted her perspective on life.

A few people spoke about the impact that their mental health had on their family, in particular their families’ responses to their hospital admissions.

Alice’s father ‘walked out in tears’ after seeing her ‘talking gibberish’ when she was heavily medicated during her first voluntary mental health unit admission.

Others talked about the impact, positive or negative, family members had on their mental health. Maria attributed her ‘illness’ in part to ‘issues’ related to her upbringing in a traditional Greek family in which she felt ‘controlled’. Brendan described how being physically distant from his son previously contributed to suicidal thoughts. However, recently, the thought of how this would affect his son has stopped Brendan from attempting to take his own life.

Tanai has felt suicidal and taken drugs in the past. She feels she ‘never went completely off the rails’ because of her relationship with her mother.